Hoping to feel a little younger before having a little one? If so, you might have to look beyond Botox or other wrinkle-smoothing injections — at least until the end of your pregnancy.

Here’s what every mom-to-be should know about Botox and pregnancy.

What is Botox?

Botox is a brand name drug that’s used for both cosmetic and medical reasons. Also known as botulinum toxin type A, Botox is made using the bacterium Clostridium botulinum

When given as a cosmetic injection (and in very small amounts!), the toxin can temporarily smooth over wrinkles — namely, frown lines, crow’s feet and forehead lines. It’s also used to treat a wide range of medical conditions, including eyelid twitching, spasticity (abnormal muscle tightness), migraines, overactive bladder, urinary incontinence and excessive sweating.

Botox works by paralyzing a muscle or blocking certain nerves that tell the muscles to move. Some of the more common side effects include pain or bruising at the injection site. Depending on what it’s used for, the effects of Botox can last anywhere from three to 12 months. 

Can you get Botox while pregnant?

It’s unclear whether Botox can harm an unborn baby, so it’s unlikely that your doctor will okay the injections for cosmetic reasons. However, if you’re getting Botox for medical reasons — for example, to treat migraines or muscle tightness — you might get the green light after all. 

Specifically, since no adequate studies have been done on pregnant women and Botox — and therefore, there’s no way to determine the drug’s safety — the Food and Drug Administration (FDA) says that Botox should only be used during pregnancy if the benefits justify the potential risks to the baby.

Much of the research that’s been done on Botox and pregnancy has been conducted in animals. While some of the studies have shown a link between botulinum toxin and fetal abnormalities, others have indicated that the drug doesn’t cross the placenta or isn’t detectable in the animal fetuses. But since you’re not pregnant with a lab rat, it’s hard to extrapolate those results to humans.

Formal experiments aside, there have been a handful of case reports about women who received Botox during pregnancy (including some who didn’t know they were pregnant at the time of the injections). Out of these women, the vast majority (the same proportion as the general popoulation) went on to have healthy babies.

If you’re considering Botox for a medical purpose during pregnancy, talk to your doctor about whether the pros outweigh the cons. And if you’re getting it for cosmetic purposes? You’re probably better off playing it safe than sorry.

Can you get Botox while breastfeeding?

It’s not known if Botox passes into breast milk, which is why the FDA encourages caution for breastfeeding moms. While some research suggests that Botox may not enter the bloodstream, the data is inconclusive — and research is scarce. 

If you’re breastfeeding and thinking about getting Botox for a medical condition like migraines or muscle tightness, talk to your doctor first. If you’re considering it for cosmetic purposes, you may want to wait.

What can you do instead of Botox while pregnant?

You can still give your skin a little TLC while you’re expecting. Here are a few pregnancy-safe alternatives to Botox:

  • Facials: Most facials — including steam and collagen facials as well as fruit acid peels and extractions — are safe during pregnancy. One exception: any facial that uses ingredients like retinoids and salicylic acid, which can enter your bloodstream.
  • Exfoliating scrubs: Good options include scrubs that contain sugar, salt, or lactic or glycolic acid. 
  • Moisturizers: Keep dry skin hydrated with a gentle lotion or cream that contains hyaluronic acid or coconut oil.

On the other hand, you may find that pregnancy gives you a recently refreshed look all on its own without having to use Botox.

That’s because normal fluid retention during pregnancy puffs up your face, filling out any unwanted crow’s feet and other lines, while hormonal changes can step up oil production in your skin — adding a youthful glow (and maybe a few youthful zits).

So don’t worry, be happy about those laugh lines — and if you aren’t happy about them, look forward to sticking it to them after your baby has arrived or weaned.